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Doctor/Patient Confidentiality and Abuse Allegations

By R. Collin Middleton
April 27, 2006

The Health Insurance Portability and Accountability Act, 42 U.S.C.A. ' 1320(d) et seq. (HIPAA), was meant to offer a baseline for the disclosure of individual medical information. The law, calling for standards to be promulgated by the Secretary of Health and Human Services, became effective in April 2001 and full compliance was required by April 2003. Crenshaw v. Mony et al., 318 F. Supp. 2d 1015, 1027 (D.S.D. Cal. 2004). The regulations are hardly a model of clarity, even for federal regulations, and frequent reference to state law and state reporting agencies can heighten the confusion.

Nowhere is the confusion over what patient information may be disclosed, and to whom, clearer than in the case of the psychiatrist's duty to report the suspected sexual abuse of a child, particularly when the health care provider does not believe the accusation. Must a doctor report every allegation or only those he believes, and if he does not believe the allegation to be true, can he disclose the patient's statement without violating confidentiality rules?

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